Definitions, epidemiology, and outcomes of persistent/chronic critical illness: a scoping review for translation to clinical practice.

Background: Medical advances in intensive care units (ICUs) have resulted in the emergence of a new patient population-those who survive the initial acute phase of critical illness, but require prolonged ICU stays and develop chronic critical symptoms. This condition, often termed Persistent Critical Illness (PerCI) or Chronic Critical Illness (CCI), remains poorly understood and inconsistently reported across studies, resulting in a lack of clinical practice use. This scoping review aims to systematically review and synthesize the existing literature on PerCI/CCI, with a focus on definitions, epidemiology, and outcomes for its translation to clinical practice.

Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.

Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

Results: A total of 6575 patients with CDB were included.

Leveraging pre-trained machine learning models for islet quantification in type 1 diabetes.

Human islets display a high degree of heterogeneity in terms of size, number, architecture, and endocrine cell-type compositions. An ever-increasing number of immunohistochemistry-stained whole slide images (WSIs) are available through the online pathology database of the Network for Pancreatic Organ donors with Diabetes (nPOD) program at the University of Florida (UF). We aimed to develop an enhanced machine learning-assisted WSI analysis workflow to utilize the nPOD resource for analysis of endocrine cell heterogeneity in the natural history of type 1 diabetes (T1D) in comparison to donors without diabetes.

The U-shaped correlation between serum VD concentration and systemic immune-inflammatory index: results from the NHANES database prospective cohort study.

Background: Vitamin D (VD) plays a critical role in regulating systemic inflammation, but its correlation with the systemic immune-inflammatory index (SII) remains unclear. This study aimed to explore the relationship between serum VD concentration, dietary VD intake, and SII using data from the National Health and Nutrition Examination Survey (NHANES).

Methods: Data from NHANES 2007-2018 and NHANES 2007-2020 were analyzed for serum VD levels and dietary VD intake, respectively.

The efficacy of coagulation factor concentrates in the management of patients with trauma-induced coagulopathy: a systematic review and meta-analysis.

Background: Death in the early phase of trauma is primarily attributable to uncontrolled bleeding exacerbated by trauma-induced coagulopathy (TIC). A comprehensive synthesis of the available evidence on interventions for TIC is needed.

Methods: We conducted a systematic review and meta-analysis of blood component products and tranexamic acid administrations for severe trauma patients with TIC.

Association between Driving Pressure, Systemic Inflammation and Non-pulmonary Organ Dysfunction in Patients with Acute Respiratory Distress Syndrome, a Prospective Pathophysiological Study.

Background: Driving pressure is thought to determine the effect of low tidal ventilation on survival in patients with acute respiratory distress syndrome. The leading cause of mortality in these patients is non-pulmonary multiorgan dysfunction, which is believed to worsen due to the biological response to mechanical ventilation (biotrauma). Therefore, we aimed to analyze the association between driving pressure, biotrauma, and non-pulmonary multiorgan dysfunction.

Decadal Evolution of KPC-related plasmids in Pseudomonas aeruginosa high-risk clone ST463 in Zhejiang, China.

Klebsiella pneumoniae carbapenemase-producing Pseudomonas aeruginosa (KPC-PA) isolates have quickly expanded in China, especially the high-risk clone ST463. We aimed to explore the evolution of KPC-related plasmids driving ST463 clone success. Whole-genome sequencing of 1258 clinical P.

Core outcome set of daily monitoring of gastrointestinal function in adult critically ill patients: a modified Delphi consensus process (COSMOGI).

Purpose: Gastrointestinal (GI) dysfunction is common in critically ill patients and associated with poor outcomes. There is a lack of standardised methods for daily monitoring of GI function. COSMOGI aimed to develop a Core Outcome Set (COS) for daily monitoring of GI function to improve consistency and comparability in future studies in critically ill patients.

Iron-glucose oxidase nanogel assembly for amplified starvation-ferroptosis anti-tumor therapy.

Developing advanced and effective enzyme-drug systems for cancer treatment is of significant interest. Herein, a novel approach is reported to create a highly active and robust enzyme-drug system. Glucose oxidase nanogels (nGOx) are first synthesized by polymerization on the surface of GOx using vinylimidazole as comonomers.

Peripheral Blood Levels of IL-27, IFABP, and DAO at Early Onset as Predictors of 28-Day Mortality in Enterogenic Sepsis Patients: A Single-Center, Prospective Pilot Study.

Background: Currently, there is a lack of serum biomarkers that can accurately predict the short-term prognosis of enterogenic sepsis.

Methods: 99 patients with enterogenic sepsis were categorized based on their Acute Gastrointestinal Injury (AGI) grade on the third day of ICU admission into four groups: no AGI, AGI grade I, AGI grade II, and AGI (III+IV). Additionally, patients were classified into survival and death groups according to their 28-day clinical outcomes.

Robotic and laparoscopic minimally invasive surgery for colorectal cancer in Africa: an outcome comparison endorsed by the Nigerian society for colorectal disorders.

Background: Minimally invasive surgery for colorectal cancer (CRC) offer superior outcomes compared to open surgery. This study aimed to review the robotic and laparoscopic procedures for CRC performed in Africa, and compare the mean surgery duration, blood loss, hospital stay, rate of conversion, and prevalence of morbidity and mortality. This is the first study to compare the outcomes of robotic and laparoscopic surgeries for CRC in Africa.

Very old patients in the ICU in Latin America: A narrative review.

The population of very elderly patients (aged 80 years and older) in intensive care units (ICUs) is steadily growing. These patients have unique physiological, cognitive, functional, and social characteristics that affect their entire ICU course. Immobility, delirium, dysphagia, malnutrition, and polypharmacy are among the most common geriatric syndromes in these patients, and they contribute to a higher risk of acute and long-term functional decline and mortality.

Association of dynamic changes in arterial partial pressure of carbon dioxide with neurological outcomes in aneurysmal subarachnoid hemorrhage.

Background: Cerebral blood flow (CBF) is closely regulated by carbon dioxide (CO). In patients with aneurysmal subarachnoid hemorrhage (aSAH), abnormal arterial partial pressure of CO (PaCO) might deteriorate brain injuries. Nevertheless, the impact of dynamic PaCO fluctuations on neurological outcomes in aSAH patients has not been extensively studied.

Modified Quick Change Method for Norepinephrine Syringe Exchange in Critically Ill Patients: A Quasi-randomized, Non-inferiority Trial.

Background: This study aimed to verify that the modified quick change (mQC) method of syringe exchange in critically ill patients receiving a continuous intravenous norepinephrine infusion is not inferior to the conventional double pumping (DP) method.

Methods: This non-blinded, quasi-randomized, non-inferiority trial was conducted in a single hospital from August 1, 2023 to February 29, 2024. Adult patients aged 18 years or older who were admitted to the emergency ward and received a continuous intravenous norepinephrine infusion were eligible for inclusion.

Lung contusion complicated by pneumonia worsens lung injury via the inflammatory effect of alveolar small extracellular vesicles on macrophages and epithelial cells.

Background: Lung contusion (LC) complicated by pneumonia is associated with a higher risk of acute lung injury (ALI) mediated by activation of immune cells and injury to the lung epithelium. Small extracellular vesicles (sEVs) are essential mediators of cellular crosstalk; however, their role in the development of postinjury ALI remains unclear. We hypothesized that LC complicated by pneumonia increases the pro-inflammatory effect of alveolar sEVs on macrophages and the cytotoxicity of alveolar sEVs to pulmonary epithelial cells, worsening the severity of ALI.

Japanese radiological technologists' perceptions and interest in disaster medicine and radiation emergency medicine.

Since the Fukushima Daiichi Nuclear Power Plant accident in Japan, there has been a growing demand for radiological technologists to play active roles in radiation emergency medicine. This study administered a questionnaire survey to determine radiological technologists' experience, interest, and confidence in disaster medicine and radiation emergency medicine as well as their educational needs, particularly regarding radiation emergency medicine. Findings showed that less than 10% of radiological technologists working at nuclear emergency core hospitals and nuclear emergency medical cooperative institutions for nuclear disaster medical care had studied disaster medicine, regardless of their affiliation, age, or years of service, and that they lacked educational experience.

The association between interleukin-8 gene polymorphism and the risk of sepsis in older adults.

Background: Previous studies on the relationship between interleukin-8 (IL-8) rs4073 polymorphism and sepsis susceptibility have covered contradictory results. Our purpose is to investigate whether this polymorphism confers a risk for sepsis using both experimental methods and meta-analysis.

Methods: In the current study, the authoritative databases including PubMed and Embase were carefully searched and reviewed.